The control of bleeding as well as sealing of air and various bodily fluids is essential and critical in surgical procedures to minimize blood loss, to seal tissue and organ structures, to reduce post-surgical complications, and to shorten the duration of the surgery in the operating room.
A two component reactive adhesive or sealant system comprised of components that can polymerize in situ to form an adhesive or sealant may be used to control such bleeding. For example, an adhesive or sealant system comprising one or more electrophilic moiety and one or more nucleophilic moiety may be prepared and delivered to a surgical site to control bleeding, or to seal tissue or organ structures. Examples of such adhesive or sealant systems are disclosed in U.S. Pat. No. 7,868,123, which is incorporated by reference thereto in its entirety. Additional examples of such adhesives include those described in U.S. Pat. Nos. 6,534,591, 6,410,645, 6,352,710, 6,217,894, 6,162,241, 6,051,248, 5,900,245, 6,969,400, 6,911,496, 6,833,408, 6,624,245, 6,495,127, 6,458,889 and 6,323,278, namely crosslinked polymer compositions that are the reaction product of a first synthetic polymer containing two or more nucleophilic groups and a second synthetic polymer containing two or more electrophilic groups capable of covalently binding with the nucleophilic groups on the first synthetic polymer. In addition to the synthetic adhesive and sealant systems described above, biologic components such as thrombin and fibrinogen have been used commercially to control bleeding. Due to the reactive nature of such two component reactive adhesive or sealant systems in the presence of moisture, the two reactive components are typically maintained separately and admixed in liquid form just prior to use in surgery to prevent premature polymerization of the components. However, one of the drawbacks associated with use of such two component reactive systems is the time required to prepare and admix the two reactive components to form the adhesive or sealant that is applied to the surgical site, and the fact that additional supplies are required to facilitate the admixing. Therefore, it is desirable to have a hemostatic device that does not require preparation and that is ready for use upon removal from its packaging.
Additionally, efforts have been made to provide dressings with enhanced hemostatic and tissue sealing and adhering properties. For example, thrombin and fibrinogen have been combined with dressing carriers or substrates, including gelatin-based carriers, polysaccharide-based carriers, glycolic acid or lactic acid-based carriers and a collagen matrix. Examples of such dressings are disclosed in U.S. Pat. Nos. 6,762,336, 6,733,774 and PCT publication WO 2004/064878 A1. Hemostatic wound dressings having one or more electrophilic moiety and one or more nucleophilic moiety disposed thereon in a dry state is also disclosed in co-pending U.S. application Ser. No. 11/942,035. Premature reaction of these two component reactive systems is avoided since the reactive components are maintained in a dry state on the dressing. However, one problem associated with using such components in dry form on a substrate is adherence of the dry components to the substrate. Therefore, it is desirable to have a hemostatic wound dressing having these two reactive components immobilized on the substrate to avoid loss of the components upon use.